Healthcare Assignment: Prenatal & Postnatal Maternal Health of Aboriginals

Question

Task: The objective of this healthcare assignment task is to not only explore various health issues, vulnerabilities, and inequities for populations with differing cultural needs, but also to reflect on your own learning and cultural awareness as a future healthcare provider.

• Describe your chosen topic and how it affects Aboriginal and Torres Strait Islander individuals and the health of the Community, outlining why it is a relevant topic to Aboriginal and Torres Strait Islander Peoples.
• Use current statistics or publications (less than 5 years old) to illustrate the burden of this topic / issue for Aboriginal and Torres Strait Islander Peoples compared with non-Aboriginal and Torres Strait Islander People.
• Describe how the history of colonisation has impacted on the development of this topic / issue for Aboriginal and Torres Strait Islander Peoples
• Discuss the cultural implications and obstacles to addressing this topic / issue for Aboriginal and Torres Strait Islander Peoples
• Students are required to engage with the Rolfe Reflective Cycle around the topic and what they have learnt about the topic. What? So What? What next?

Answer

Section 1: Healthcare Assignment Topic discussion
Maternal health refers to the health of the women during childbirth, pregnancy as well as in the postnatal period. This stage provides a positive experience assuring that both the women and their children reach the ultimate potential of health and well-being. The provision of quality maternal healthcare ensures the improved health of the mother as this health can be considered to be important for the new child as well as the other family. The concept of maternal health is related to the Aboriginal and the Torres Islanders as it has been found that there existed persistent disparities in the birth outcomes and pregnancy that requires responsive practices (Vermeiden&Stekelenburg, 2017). This post and pre-natal maternal health can be considered to be a global problem and thus its impact lies on the general population. There has to be a significant level of improvements made in the health outcomes for the infants and the mothers globally where the Aboriginal still faces a much poorer level of maternal and child health outcomes compared to the non-aboriginals (Gould et al., 2017). The issues faced by the Indigenous Australian mothers during childbirth includes malnutrition, poor economic status, remoteness, maternal cigarette smoking, teenage pregnancy, genitourinary tract infection and poor level of antenatal care (Belton et al., 2018).

Post-natal and prenatal maternal health affects the health of the mothers as well as the quality of life of the children among the Aboriginals. It is important to take appropriate steps for maintaining the overall health of the mothers during pregnancy (Gouldet al., 2017). In doing so, the mothers must lay focus on the vaccination history as well as the maternal healthcare. Moreover, vaccinations are also important for the overall healthcare of pregnant women. The medical team also discusses the vaccination history of the pregnant women and thus determines the complications that are to be taken care of during the pregnancy and after childbirth (Mahet al., 2017).

The post-natal and pre-natal maternal health affects the health of the community by ensuring the good health of the newborn child as well as the other family members. The mothers, as well as their family members, must be encouraged to visit the health centers during and after childbirth (Beltonet al., 2018). Moreover, it is important to take proper care so that the Indigenous Australians do not rely on the traditional birth process in the community as this can be considered as the only support to maternal healthcare (Hickey et al., 2018). The family members of the Indigenous must also be provided training to support maternal health and thus it must be passed through from one generation to another.

Section 2: Topic comparison
According to the report of UN.org (2021), it has been found that most Indigenous women die during pregnancy and childbirth compared to other women. The failure to act according to this will render the unattainable sustainable developmental goals.

The indigenous women experience worse maternal healthcare outcomes compared to other populations. Although there is the availability of limited data, the survey from the low and middle-income countries highlighted that the three important indicators linked with the health of the adolescent and the indigenous women are more likely to benefit from the services and thus possess poor maternal health outcomes. Further, there also exists discrimination experienced by the adolescent and the indigenous women and thus this extends to the industrialized countries across varied regions in Australia.

The study conducted by Kozhimannilet al. (2020) opined that the incidence of maternal mortality and morbidity among the Indigenous linked with childbirth are twice high among the Indigenous compared with the non-Indigenous. These indicatemore risk of maternal mortality among the Indigenous compared to the non-Indigenous. Further, it has been found that the highest level of occurrence of maternal morbidity and mortality are observed among the indigenous residing in the rural Australian region (Gibson-Helm et al.,2018). It is essential to address the varied connection betweenrisks based on the place and the race inequities that require the inclusion of the rural and the indigenous individuals in the implementation and the planning of maternity improvement care.

The study carried out by AIHW (2021) stated that Indigenous mothers accounted for 4.8% of the women giving birth. There has been a considerable level of improvements in the health of Indigenous mothers in these recent years and it is found that the number of indigenous mothers attending antenatal care has increased from 49% in 2012 to 67% in 2019. Moreover, there has been an increase in the number of antenatal visits of pregnant Indigenous women from 77% in 2012 to 88% in 2019. On the other hand, the proportion of Indigenous pregnant women or ante-natal mothers reporting smoking has been reduced from 20% in 2009 to 11% in 2019 (AIHW, 2021). Further, the remoteness area also lays effect on the key statistics for the Indigenous mothers as well as the children. However, despite the improvements made in the medical system, it has been found that the indigenous babies, as well as the mothers, continue to experience poorer levels of health outcomes compared to the non-indigenous across varied areas.

Section 3: History and Colonisation
The economic, cultural, political, and social histories can be regarded as the course of action that is to be undertaken by the health professionals when collaborating with the Aboriginal and the Torres Strait maternal mothers. Economic: The Aboriginal women with lower income level possess a higher chance of maternal death especially the ones who reside in the rural areas or has delivery through cesarean section.

Political: The history of paternalistic government decisions has created barriers towards the maternal health of Indigenous women. The varied manifestation of colonization included the displacement of the Aboriginal and the Torres Islanders as well as the breakdown of the cultural values through the missionaries and the government legislation, the policies, and the acts.

Cultural: The health researchers must try their best to understand how the health of the Aboriginal and the Torres Islanders is affected through the social health determinants which is a crucial health competency (Gould et al., 2017). There has been an increased level of disparities among the Indigenous maternal mothers that includes the lower level of educational attainment, sustained institutional racism, poverty as well as culturally appropriate health services. The varied types of healthcare services also contribute to the lower level of disparities among the Aboriginal maternal mothers as well as their infants such as the provision of appropriate and effective maternal healthcare in time (Vermeidenet al., 2017).

Social factor: The poorer uptake of health services can also be considered to be associated with the cost, geographic isolation, the lack of trust as well as negative experiences or unsafe delivery practices (Belton et al., 2018). Moreover, the Aboriginal women are less likely to receive care than the non-Aboriginal counterparts for attending to the mainstream health services, commencing the antenatal care at the scheduled time, and attending the number of antenatal visits. This can be considered to be much higher in infant and maternal healthcare in remote areas involving multiple providers across the varied sectors of health (Mahet al., 2017). On the other hand, it has been found that the healthcare professionals among the Aboriginals are trained inadequately and thus they are unprepared to carry out the work cross-culturally by tackling the situation.

Section 4: Cultural implications of the chosen topic
Cultural responsiveness: The cultural customs, values, and beliefs affect the maternal health of Indigenous mothers thereby increasing the case of likelihood of maternal death. There has to be a specific level of understanding of how the culture is associated with the maternal mortality of Indigenous women by providing them the culturally competent care as well as through the design of the effective level of programs (Belton et al., 2018).

The obstacles linked with the maternal health of Indigenous women include physical abuse, psychosocial challenges, unfriendly adolescent services, denial of human rights, lack of birth, and the lack of cultural and legal protection (Mahet al., 2017). Further, some of the maternal women also face the challenge of injuries, cancer, respiratory diseases, substance, and mental use disorder.

The Indigenous health model includes the ecological framework considering the personal and environmental factors affecting the health of the maternal mothers. The physical, emotional, spiritual, mental holistic health includes the natural creation and the environment (Kotzet al., 2021). The providers of health care must consider the roles, protocols, and teachings in the provision of maternal care.

Section 5: Reflection
Rolfe’s model reflective framework includes the descriptive level, the theory, and the knowledge building as well as the action-oriented reflection. After carrying out the entire analysis, I have found that the maternal health of the Indigenous mother has been affected to a great extent. I have found that the pre-natal and the post-natal maternal care of indigenous women are much more critical than the non-indigenous. It is important to take appropriate care of the maternal mothers so that there is a reduction of the gap between the Indigenous and the non-Indigenous.

To lower the gap between the Indigenous maternal mothers, there has to be an improved level of coordination between the healthcare professionals, the family members, and the nurses. The women must also be provided with classes on the importance of maternal health so that it becomes easier for them to understand their concerns and the problems. The professional standard associated with the maternal care of Indigenous mothers includes the fifth standard where women and newborn babies are likely to be provided with respect and dignity for the provision of care (WHO, 2021).

It is the responsibility of the Australian government to consult the community members of the Indigenous population and thus educate them to take care of the maternal mothers. I think that with the help of positive action, the indigenous maternal mortality among the indigenous population can be reduced to the national average level.

References
AIHW. 2021. Australian mothers and babies. Retrieved 23 October 2021, from https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies-2017-data-visualisations/contents/special-interest-groups/indigenous-mothers

Belton, S., Kruske, S., Pulver, L.J., Sherwood, J., Tune, K., Carapetis, J., Vaughan, G., Peek, M., McLintock, C. &Sullivan, E. (2018). Rheumatic heart disease in pregnancy: How can health services adapt to the needs of Indigenous women? A qualitative study. Australian and New Zealand Journal of Obstetrics and Gynaecology, 58(4),425-431.https://doi.org/10.1111/ajo.12744

Fact Sheet.(2021). Indigenous Women’s Maternal Health and Maternal Mortality.Retrieved 23 October 2021, from https://www.un.org/development/desa/indigenouspeoples/wp-content/uploads/sites/19/2018/04/factsheet_print_Mar27.pdf Gibson-Helm, M.E., Bailie, J., Matthews, V., Laycock, A.F., Boyle, J.A. &Bailie, R.S., 2018.Identifying evidence-practice gaps and strategies for improvement in Aboriginal and Torres Strait Islander maternal health care. PloS one, 13(2), p.e0192262.https://doi.org/10.1371/journal.pone.0192262

Gould, G.S., Patten, C., Glover, M., Kira, A. &Jayasinghe, H. (2017). Smoking in pregnancy among Indigenous women in high-income countries: a narrative review. Nicotine & Tobacco Research, 19(5), 506-517.doi: 10.1093/ntr/ntw288 Hickey, S., Roe, Y., Gao, Y., Nelson, C., Carson, A., Currie, J., Reynolds, M., Wilson, K., Kruske, S., Blackman, R. &Passey, M. (2018). The Indigenous Birthing in an Urban Setting study: the IBUS study.Healthcare assignment BMC pregnancy and childbirth, 18(1), 1-12.https://doi.org/10.1186/s12884-018-2067-8

Kotz, J., Marriott, R., & Reid, C. (2021). The EPDS and Australian Indigenous women: a systematic review of the literature. Women and Birth, 34(2), e128-e134.https://doi.org/10.1016/j.wombi.2020.02.007

Kozhimannil, K.B., Interrante, J.D., Tofte, A.N. &Admon, L.K. (2020).Severe maternal morbidity and mortality among indigenous women in the United States. Obstetrics and gynecology, 135(2), 294.doi: 10.1097/AOG.0000000000003647 Mah, B., Weatherall, L., Burrows, J., Blackwell, C.C., Gwynn, J., Wadhwa, P., Lumbers, E.R., Smith, R. &Rae, K.M. (2017).

Post?traumatic stress disorder symptoms in pregnant Australian Indigenous women residing in rural and remote New South Wales: A cross?sectional descriptive study. Australian and New Zealand Journal of Obstetrics and Gynaecology, 57(5), 520-525.https://doi.org/10.1111/ajo.12618

Vermeiden, T. &Stekelenburg, J. (2017). Commentary: maternity waiting homes as part of an integrated program for maternal and neonatal health improvements: women’s lives are worth saving. J Midwifery Women’s Health, 62(2), 151-154.Doi:10.1111/jmwh.12618

WHO (2021).Standards for improving quality of maternal and newborn care in health facilities.Retrieved 23 October 2021, from https://www.who.int/docs/default-source/mca-documents/advisory-groups/quality-of-care/standards-for-improving-quality-of-maternal-and-newborn-care-in-health-facilities.pdf